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Pulmonary Med
Pulmonary Meds shortened
| Question | Answer |
|---|---|
| Glucocorticoids | Vancenase, Flonase, Nasonex, Nasocort & Pulmicort |
| Leukotriene Modifiers | Singulair & Zyflo |
| Methylxanthines | theophylline |
| Beta 2 Adrenergic Agents | Xopenex, Albuterol, Serevent, Advair |
| Oral Anti-histamines | Benadryl, Tavist, Chlor-trimeton, Claritin, Zyrtec, Allegra, Clarinex |
| Decongestants | Sudafed, Dristan, Neo-synephrine |
| Anticholinergic | Spiriva & Atrovent |
| Coughing | Codeine, Dextromethopan, Mucinex & Mucomyst |
| Antifungal | Amphotericin B, Azoles (Diflucan, Sporanox, Vfend |
| Antimetabolites | Trimethoprim & Sulfonamides |
| Penicillins | Pipracil, Zolsyn, Augmentin, Penicillin G |
| Cephalosporins | Maxipime, Rocephine, Cefzil, Cefazolin |
| Carbapenems | Primaxin |
| Tetracyclines | Doxycycline & Tetracycline |
| Macrolides | Biaxin & Zithromax |
| Aminoglycosides | Gentamycin |
| Fluoroquinolones | Cipro & Levaquin |
| Azoles | Diflucan, Vfend, Sporanox |
| TB Meds | INH, Rifadin, PZA & myambutol |
| Chemo Agents | Taxol & Paraplatin |
| Vancenase, Pulmicort, Flovent/Flonase, Nasonex, Nasocort | Most effective antiasthma drug. S/E: with chronic use: adrenal suppression, bone loss, oropharyngeal candidiasis & dysphonia, hyperglycemia, displacement of fatty tissue, decreased healing |
| Nasonex & Nasocort | Intranasal. S/E: drying of nasal mucosa, burning/itching, sore throat, epistaxis, not as effective if nasal congestion is present |
| Zyflo | blocks leukotriene synthesis; used for adults and kids >12; hepatotoxic, monitor ALT, competes with theophylline, coumadin |
| Singulair | Leukotriene receptor blocker; used prophylactically & maintenance; prevention of exercise induced bronchospasm; relief of allergic rhinitis; not immediate or hepatotoxic |
| NasalCrom (Intranasal), Intal (Inhalation) | Effective for seasonal allergy attacks, and exercised induced bronchospasm, give 15 min before. Decreases bronchial inflammation, not a bronchodilator. Used prophylactically, not quick relief, no systemic effects, can be used instead of steroids |
| Theophylline | causes bronchodilation; narrow therapeutic range. Given PO. Wide variations in metabolic rates = therapeutic is 5-15, levels 20-25 cause nausea, vomiting, restlessness; >30 dysrhythmias (Vfib) and seizures. Avoid w/ caffeine. Not commonly used |
| Albuterol & Xopenx (short acting Beta 2 Adrenergic Agonist) | Given inhalation, immediate effect, peaks 30-60 mins, persist for 3-5 hrs. If used for exercise induced bronchospasm take 15 min before. S/E: increase HR, agina, tremor |
| Serevent (long acting Beta 2 Adrenergic Agonist) | Given PO or inhalation q12 hrs; not first choice for attack, not to be used alone - use w/ steroid. Onset begins 10-30 minutes |
| Advair | Combo Beta 2 Adrenergic Agonist |
| Chlor-Trimeton, Benadryl, Tavist (1st Generation oral antihistamines) | Relieves rhinorrhea, sneezing, nasal itching, but NOT congestion. Take on a regular basis. S/E: sedation, dry mouth, urinary hesitancy, constipation due to anticholinergic effects |
| Zyrtec, Allegra, Claritin, Clarinex (2nd Generation oral antihistamines) | Relieves rhinorrhea, sneezing, nasal itching but not congestion. Take on a regular basis. S/E: few, NO SEDATION |
| Neosynephrine, Sudafed, Dristan (Decongestants) | Decrease nasal congestion by vasoconstricting, shrinks swollen membranes. Used for allergic rhinitis to relieve stuffiness. S/E: rebound congestion, limit 3-5 day use, CNS excitation, restless, anxiety, watch cardiac patients |
| Sudafed | Can be converted to methamphetamine, must be kept behind counter |
| Atrovent | Onset 30 seconds, max 3 min. Lasts up to 6 hrs. S/E: dry mouth, irritation of pharynx, avoid if peanut allergy |
| Spiriva | Long acting, onset 30 minutes, peak 3 hrs, lasts 24 hrs. Given 1x daily. S/E: dry mouth, DPI, additive benefits w/ Beta 2 |
| Codeine | Decreases frequency/intensity of cough; low dose, 1/10 of dose used for pain; potential for abuse |
| Dextromethophan | Non-opiod antitussive; taken at high doses can cause euphoria |
| Mucomyst | Given by inhalation; watch for bronchospasm, contains sulfur |
| Mucinex & Mucomyst | Expectorant stimulates flow of respiratory secretions, mucolytics breaks up mucus |
| Penicillin G | active against most gram + bacteria, most gram - are resistant. Given IM or IV, intra arterial injection can produce severe reactions (gangrene, necrosis) must AVOID |
| Pipracil | Broad spectrum, given IV, decrease dosing for impaired renal function. |
| Zosyn | Contains tazobactam which is a beta lactamase inhibitor (prevents the bacteria's beta lactase enzyme from breaking down the antibiotic which is piperacillin) |
| Augmentin | May be given orally; S/E: rash & diarrhea. Clavulanate is a beta lactamse inhibitor protecting the amoxocillin from the bacteria's beta lactamase enzymes |
| Cefazolin | Destroyed by beta lactamase enzymes; used for gram +. Binds to PCN binding proteins; has a beta lactam ring, bactericidal; most effective against bacteria undergoing cell division and growth. Given IV/IM |
| Cefzil & Ceftin | Less sensitive to beta lactamase enzymes. Does not reach CSF. Used for active infection; prophylactically w/ surgical patients |
| Rocephin & Maxipime | Highly resistant to beta lactamases. Reserved for active infections, strong antibiotics "BIG GUNS" |
| Cephalosporins | S/E: hypersensitivity reactions. Rash for several days after onset of use, risk for bleeding (interferes w/ Vit K metabolism), thrombophlebitis. Usually given IV/IM - eliminated by kidneys |
| Rocephin | Do not mix w/ calcium containing IVF/IVPB |
| Primaxin | Very broad spectrum, beta lactamase antibiotic given IV only. Binds to PCN binding proteins, resistant to many beta lactamases; penetrates gram - outer membrane. Penetrates CSF, elimination by renela. S/E: N/V, diarrhea, hypersensitivity |
| Vancomycin | Should be reserved for serious infections (CDIFF, MRSA, allergy to PCN). S/E: nephrotoxic, ototoxic (ringing in ears, hearing loss). Rapid infusion may cause "Red man syndrome". Do peaks & troughs |
| Azactam | Contains beta lactam ring. Binds to PCN binding proteins, NOT effective against anaerobes or gram + bacteria. S/E: pain & thrombophlebitis at injection site. Treats gram - aerobic bacteria. Given IM/IV |
| Tetracycline | Take on empty stomach, eliminated by kidneys, avoid w/ renal failure. Take w/ full glass of water, use straw/avoid contact w/ teeth. Treats: chlamydia, lymes diase, h pylori, acne |
| Doxycycline | Can take w/ food, eliminated by liver, OK to use w/ renal failure. S/E: discolors teeth. Treats: chlamydia, lyme's disease, h pylori, acne |
| Biaxin | Used for resp tract infections, h pylori, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. S/E: GI Upset, QT prolongation |
| Zithromax | Treats respiratory infections, chlamydia, pertusis, whooping cough, diptheria, chlamydia, some pneumonia. Absorption increases w/ food. |
| Cleocin | Used for severe Group A strep infections. S/E: pseudomembranous colitis, CDIFF (profuse watery diarrhea, abdominal pain, fever, leukocytosis, stools positive for mucus and blood) |
| Zyvox | Used for VRE, MRSA, gram + bacteria. S/E: myelosuppression AKA decreases WBC, RBC, platelet |
| Gentamycin | Used for Aerobic gram - bacilli, cannot kill anaerobes, need O2 to transport medication across membrane. Given IV only, may give PO for bowel infection only. S/E: ototoxic, nephrotoxic, monitor peaks & troughs |
| Cipro & Levaquin | Used for respiratory, urinary, GI, bone, joints, skin & soft tissue infections. S/E: tendon (achilles) rupture, GI upset, candida of pharynx and vagina. CNS - dizziness, confusion. Absorption decreases w/ Al, Mg, Fe, Ca, dairy |
| Flagyl | Used for CDIFF, abdominal and vaginal surgery, h pylori. S/E: metallic taste, darkening of urine, nausea, headache, dry mouth. Avoid alcohol, may need to decrease alcohol |
| Amphotericin B | Active against broad spectrum fungi. Premedicate w/ Benadryl & tylenol, corticosteroids. Renal impairment occurs in almost all patients; avoid other nephrotoxic drugs, bone marrow suppression. BIG, DANGEROUS DRUG |
| Sporanox | Take with food, do not take w/ antacids. Broad spectrum anti-fungal |
| Diflucan, Vfend, Sporanox | Broad spectrum anti-fungals. Given PO. Used for blastomycosis, histoplasmosis, candidiasis. S/E: cardiosuppression and liver injury |
| Cancidas | Used for aspergillus or candida only. Given IV. S/E: phlebitis. Better tolerated than Ampho B |
| INH | Bactericidal to actively dividing organisms. Must be taken for 6 mos prefer 9. S/E: liver damage, peripheral neuropathy due to lowered vit B6 |
| Rifadin | Bactericidal to TB. Take on empty stomach. S/E: Red,orange discoloration of urine, sweat, tears, saliva |
| PZA | Bactericiidal to TB, hepatotoxic, increases uric acid |
| Myambutol | Bacteriostatic, used to treat TB resistant to INH or Rifadin. S/E: optic neuritis (blurred vision, constriction of visual field, changes to color discrimination), inhibits uric acid excretion |
| Zovirax | Active only against herpes virus family (chicken pox, herpes, shingles). |
| Paraplatin | Used for small cell lung cancer. S/E: bone marrow suppression, nausea, vomiting. Nephrotoxic, watch for hearing loss |
| Taxol | Used for non small cell lung cancer. S/E: severe hypersensitivity infusion, bone marrow suppression, alopecia, bradycardia. Premedicate w/ Benadryl/corticosteroids. |
Created by:
kristyd02
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